title: Total microvessel perimeter per tumor area is a predictor of radiosensitivity in early-stage glottic carcinoma.
abstract: OBJECTIVE
  To confirm that total number of microvessels per tumor area (TN/TA) and total microvessel perimeter per tumor area (TP/TA) are predictors for radiosensitivity in early-stage glottic carcinoma.
  
  
  METHODS
  One hundred twenty consecutive patients with T1-2N0M0 glottic cancer who were treated with radical radiotherapy in three different hospitals in Japan were included in this study. Biopsy specimens from patients were immunostained with anti-CD31 antibody. The TN/TA and TP/TA of each sample were analyzed using a computer-assisted image analysis system. Patients were stratified into high and low groups according to the cut-off values derived from receiver operating characteristic curve analysis. Progression-free survival rates of the different groups were compared. The relationship of microvessel perimeter to vessel maturation was also discussed.
  
  
  RESULTS
  Survival analysis showed higher TP/TA to be associated significantly with longer progression-free survival, as compared with the lower-level group (p = 0.031). In multivariate analysis, both TP/TA (p = 0.037) and T stage (p < 0.001) proved to be independent predictive factors. Microvessel perimeter correlated closely with vessel maturity, which suggests that a tumor with high TP/TA contains more functional vessels and as a result contains more oxygenated and radiosensitive cells.
  
  
  CONCLUSIONS
  Assessment of TP/TA in biopsy specimens, using a computer-assisted analysis system, can predict the radiosensitivity of early-stage glottic carcinoma. High TP/TA may be a better indication for radiotherapy than for partial laryngectomy or laser excision.
authors.affiliation: Department of Radiation Oncology, University of Texas Southwestern Medical Center, Dallas, TX, USA.
authors.forename: Shichuan
authors.initials: S
authors.lastname: Zhang
authors.forename: Ryuichi
authors.initials: R
authors.lastname: Hayashi
authors.forename: Masato
authors.initials: M
authors.lastname: Fujii
authors.forename: Yasuhisa
authors.initials: Y
authors.lastname: Hasegawa
authors.forename: Kunitoshi
authors.initials: K
authors.lastname: Yoshino
authors.forename: Masashi
authors.initials: M
authors.lastname: Fukayama
authors.forename: Atsushi
authors.initials: A
authors.lastname: Ochiai
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000098:blood supply / Q000401:mortality / Q000532:radiotherapy*; D005260:Female; D005931:Glottis / Q000098:blood supply*; D006801:Humans; D007822:Laryngeal Neoplasms / Q000098:blood supply / Q000401:mortality / Q000532:radiotherapy*; D008297:Male; D055806:Microvessels / Q000473:pathology*; D008875:Middle Aged; D015999:Multivariate Analysis; D012372:ROC Curve; D011836:Radiation Tolerance; D055815:Young Adult